Recurrent Gynandroblastoma with Juvenile Granulosa Cell component, a very rare ovarian tumor in a 29-year-old patient: A Case Report

Articles in Press

Document Type : Case report

Authors

1 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Pathology department; faculty of medicine; ; medical unversity of medical science; Mashhad; Iran

3 Pathology department; faculty of medicine; Mashhad university of medical science

4 Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Pathology department; faculty of medicine; ; medical unversity of medical sceince; Mashhad; Iran

6 Radiology department; faculty of medicine; medical unversity of medical science; Mashhad; Iran

10.22038/ijogi.2024.79085.6053

Abstract

Introduction: Ovarian Sex cord Stromal tumors present with ovarian masses. Their symptoms and signs are result from increased hormone secretion. Gynandroblastoma is a rare tumor consisting of two components: granulosa cell tumor and Sertoli or Sertoli-Leydig cell tumor. In this study, a rare case of recurrent gynandroblastoma consisting of Juvenile Granulosa cell and Sertoli cell tumor is reported.

Case Presentation: A 29-year-old woman was referred to a medical center in Turkmenistan, with irregular menstruation and spotting for one year and progressive abdominal pain for the past four months. A mass in the left ovary was reported on CT SCAN. The patient underwent left salpingo-oophorectomy surgery, and one pathologist diagnosed Granulosa cell tumor, while another diagnosed Androblastoma. 18 months later, the patient returned with abdominal pain, and an intra-peritoneal mass was seen on MRI, leading to laparotomy. The pathologic diagnosis was Androblastoma. The patient came to Iran for treatment and the pathology slides were sent to the Pathology Department of Qaem University Hospital. After reviewing the slides of both surgeries, sections showed neoplastic lesion composed of Juvenile Granulosa cell tumor (70%) and well differentiated Sertoli cell tumor (30%), establishing the recurrent Gynandroblastoma.

Conclusion: Inadequate sampling of the tumor specimen and lack of sufficient accuracy in microscopic examination easily lead to the misdiagnosis of Gynandroblastoma. Due to the risk of recurrence, all patients should be followed up for several years. Furthermore, Genetic screening for DICER1 mutation is important.

Keywords: Ovarian Neoplasms, Sex Cord-Stromal Tumors, Gynandroblastoma, Granulosa Cell Tumor

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The Iranian Journal of Obstetrics, Gynecology and Infertility

Articles in Press, Accepted Manuscript
Available Online from 16 June 2024

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